MEDICARE: KRISTY NGUYEN PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	03439681	OH

General Provider Information

NPI Number	:	1205422532
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY NGUYEN PHARMD

Provider Business Mailing Address
First Line	:	4871 BRANTFORD CT
Second Line	:
City	:	WEST CHESTER
State	:	OH
Zip	:	45069-5503
Country	:	US
Telephone Number	:	513-291-1151
Fax Number	:

Provider Business Practice Location Address
First Line	:	260 STETSON ST STE F
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45219-5000
Country	:	US
Telephone Number	:	513-878-3426
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2020
Last Update Date	:	12/21/2020

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